Works detail

Grid reference / Postcode

GPS location
Type of works

Silt sample required?
Silt sample cannot be taken because?

Number of men required for task

Inlet Structure

Culvert inlet

Inlet found?

Photo of Inlet structure

Comments

Photo of Watercourse upstream from inlet

Comments

Height (mm)

Width (mm)

Water depth (mm)

Material

Shape

Type

Vegetation clearance required?

Assumed silt level?

Land Owner Details:

Land access payment?

Additional notes

Overhead services

Outlet structure

Culvert outlet

Outlet found ?

Photo of outlet structure

Comments

Photo of watercourse downstream from outlet

Comments

Height (mm)

Width (mm)

Water depth (mm)

Material

If other please detail

Shape

Type

Vegetation clearance required?

Assumed silt level?

Land Owner Details:

Land access payment ?

Additional notes

Overhead services

Additional photographs

Additional photos
Additional photo 1

Note

Additional photo 2

Note

Additional photo 3

Note

Additional photo 4

Note

Additional photo 5

Note

Additional photo 6

Notes

Pollution & environmental control

Identified Hazards, Environmental & pollution control
Damming required

Pollution controls

Details of other environmental hazards identified

Sign off

Other comments ( minor works , observations etc

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.